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Implementing the Mandates Imposed on Covered Entities By Section 1557 of the ACA

By Andrew Zwerling and Marianne Monroy
February 01, 2017

Section 1557 of the Affordable Care Act (ACA) is the anti-discrimination component of the ACA that prohibits discrimination in specified federally funded health care programs and activities on the basis of race, color, national origin, sex, age or disability. Section 1557 supplements pre-existing anti-discrimination laws and was designed for the purpose of enhancing access to health care and health care coverage to members of the patient population whose access has been impeded by discrimination.

Section 1557 breaks new ground in that it is the first federal civil rights law to ban sex discrimination in health care programs and activities. In this context, sex discrimination encompasses, but is not limited to, discrimination predicated upon a person's sex, including pregnancy and related medical conditions, termination of pregnancy, gender identity and sex stereotypes. The statute's broad reach encompasses all health programs and activities that receive federal financial assistance from the United States Department of Health and Human Services (HHS); all health programs and activities administered by entities created under Title I of the ACA; and all health programs and activities administered by HHS (for example, the Medicare Program and federally-facilitated marketplaces). These entities are collectively referred to as “Covered Entities.”

Section 1557 imposes requirements on Covered Entities in order to achieve the objectives of the statute. This article discusses those obligations and the consequences of a Covered Entity's failure to fulfill those mandates.

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